Ulipristal

Information about Ulipristal

Ulipristal acetate is a selective progesterone receptor modulator that is used in a single oral dose for emergency contraception.

Liver safety of Ulipristal

Use of ulipristal has not been associated with serum enzyme elevations or with clinically apparent liver injury with jaundice.

Mechanism of action of Ulipristal

Ulipristal (ue" le pris' tal) is a selective progesterone receptor modulator that is used in a single oral dose within 5 days of unprotected intercourse or suspected contraceptive failure as a means of emergency contraception. Ulipristal acts as a mixed, partial agonist and antagonist of the progesterone receptor and is believed to act by preventing both ovulation and fertilization. Unlike levonorgestrel, ulipristal can be used up to 5 days after the episode of unprotected intercourse, being effective both before and during the early phase of the luteinizing hormone (LH) surge. Ulipristal has minor effects on the uterine epithelium that may inhibit implantation. In large prospective studies, ulipristal was found to lower the rate of unwanted pregnancies by 50% to 90% of the expected rate when given up to 5 days after unprotected intercourse or suspected contraceptive failure. The overall failure rate of emergency contraception with ulipristal has ranged from 0.9% to 2.1%, the expected rates being in the range of 5% to 6%.

FDA approval information for Ulipristal

Ulipristal was approved in the United States for use in emergency contraception in 2010 and remains available by prescription as tablets of 30 mg under the brand name Ella. The recommended regimen is a single oral dose of 30 mg within 5 days of the unprotected intercourse or suspected contraceptive failure.

Side effects of Ulipristal

Side effects are generally mild-to-moderate in severity and can include headache, nausea, abdominal pain, dysmenorrhea, breast tenderness, fatigue, and dizziness.

Ulipristal has also been evaluated as nonsurgical therapy of uterine fibroids. When given in daily doses of 5 to 10 mg for 2 to 3 months, ulipristal was found to decrease uterine bleeding and total fibroid volume.

Side effects of Ulipristal

Side effects included amenorrhea, headaches, hot flushes, nausea, vomiting, abdominal cramps and menorrhagia.

Obstetrical and Gynecological Agents

• Emergency contraceptive agents
  • Levonorgestrel, Ulipristal

• Estrogens and Oral contraceptives

• • Selective estrogen receptor modulators
    • Bazedoxifene, Ospemifene, Raloxifene
  • Infertility agents

• Antiestrogens
  • Clomiphene, Letrozole, Tamoxifen

• Gonadotropins
  • Chorionic gonadotropin, Follicle stimulating hormone, Luteinizing hormone, Human gonadotropin releasing hormone

• Pregnancy termination agents
  • Mifepristone
• Progesterone and the Progestins

• Dailymed label info on Ulipristal
• FDA Ulipristal

Ulipristal Resources
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